Objective To investigate the expression of miR-204 and silence information regulator 1(SIRT1)in colorectal cancer and their clinical value.Methods Cancer tissue specimens and paracancer tissue specimens of 60 patients with colorectal cancer treated in Department of Gastrointestinal Surgery of Affiliated Hospital of Jiaxing University from May 2018 to June 2020 were collected as study objects.Real time fluorogenic quantitative polymerase chain reaction was used to detect the gene expression of miR-204 and SIRT1,and the correlation between miR-204 and SIRT1 gene expression was compared by Pearson analysis.Immunohistochemical SABC method was used to detect SIRT1 protein expression,and relationship between different SIRT1 protein expression and clinicopathological features was compared.Kaplan-Meier method was used to analyze the survival difference of colorectal cancer patients with different SIRT1 protein expression.Results The mRNA expression of miR-204 gene in cancer tissues was significantly lower than that in paracancer tissues(P<0.05),and the mRNA expression of SIRT1 gene was significantly higher than that in paracancer tissues(P<0.05).Pearson correlation analysis showed that miR-204 was negatively correlated with SIRT1 mRNA expression in both paracancer tissues and cancer tissues(r=-0.647,-0.737,P<0.05).The expression of SIRT1 protein was correlated with the differentiation level,invasion level,lymph node metastasis and TNM stage of colorectal cancer(P<0.05),but not with patient age,gender,tumor size and tumor site(P>0.05).Kaplan-Meier analysis showed that the survival rate of patients with positive expression of SIRT1 in cancer tissues was significantly lower than that of patients with negative expression of SIRT1(χ2=5.001,P=0.025).Conclusion The expression of miR-204 is down-regulated and SIRT1 expression is up-regulated in colorectal cancer tissues,which may jointly promote the metastasis and invasion of colorectal cancer and affect the prognosis of patients through mutual influence.

OBJECTIVE: To investigate the expression of microRNA miR-431-5p in gastric cancer (GC) tissues and its effects on apoptosis and mitochondrial function in GC cells. METHODS: The expression level of miR-431-5p in 50 clinical samples of GC tissues and paired adjacent tissues was detected using real-time fluorescence quantitative PCR, and its correlation with the clinicopathological features of the patients was analyzed. A cultured human GC cell line (MKN-45 cells) were transfected with a miR-431-5p mimic or a negative control sequence, and the cell proliferation, apoptosis, mitochondrial number, mitochondrial potential, mitochondrial permeability transition pore (mPTP), reactive oxygen species (ROS) production and adenosine triphosphate (ATP) content were detected using CCK-8 assay, flow cytometry, fluorescent probe label, or ATP detection kit. The changes in the expression levels of the apoptotic proteins in the cells were detected with Western blotting. RESULTS: The expression level of miR-431-5p was significantly lower in GC tissues than in the adjacent tissues (P < 0.001) and was significantly correlated with tumor differentiation (P=0.0227), T stage (P=0.0184), N stage (P=0.0005), TNM stage (P=0.0414) and vascular invasion (P=0.0107). In MKN-45 cells, overexpression of miR-431-5p obviously inhibited cell proliferation and induced cell apoptosis, causing also mitochondrial function impairment as shown by reduced mitochondrial number, lowered mitochondrial potential, increased mPTP opening, increased ROS production and reduced ATP content. Overexpression of miR-431-5p significantly downregulated the expression of Bcl-2 and increased the expressions of pro-apoptotic proteins p53, Bcl-2 and cleaved caspase-3 protein. CONCLUSION The expression of miR-431-5p is down-regulated in GC, which results in mitochondrial function impairment and promotes cell apoptosis by activating the Bax/Bcl-2/caspase3 signaling pathway, suggesting the potential role of miR-431-5p in targeted therapy for GC.
Humans ; Apoptosis/genetics* ; bcl-2-Associated X Protein ; Caspase 3 ; Cell Line, Tumor ; Cell Proliferation/genetics* ; MicroRNAs/metabolism* ; Mitochondria/metabolism* ; Mitochondrial Permeability Transition Pore ; Reactive Oxygen Species ; Stomach Neoplasms/pathology*

Objective:To investigate the prevalence of Mycoplasma pneumoniae ( Mp) in children undergoing physical examination. Methods:This study randomly enrolled 1 303 children at the age of 6-12 years who underwent physical examination in 2023. Their oral and pharyngeal swabs as well as venous blood samples were collected. The prevalence of Mp in these subjects was detected using isolation and culturing, nucleic acid detection and serological test. Chi-square test was used for statistical analysis. Results:Among the 1 303 children, the detection rate of Mp was 4.1% (53/1 303) by culturing, 7.3% (95/1 303) by nucleic acid detection and 13.6% (177/1 303) by serological test. Statistical analysis showed that there were significant differences in the the detection rates of Mp among children undergoing physical examination between the three methods ( P<0.05). Conclusions:The detection rate of Mp in children undergoing physical examination in 2023 was about 4.1%. Isolation and culturing was more accurate than nucleic acid detection and serological test in the detection of Mp in healthy population as the latter two methods would overestimate the rate.

Objective:To investigate the application value of the PDCA cycle in increasing the rate of timely completion of a rapid frozen-section pathological report.Methods:The basic data of 1 926 rapid frozen section pathological reports not managed by the PDCA cycle in the Department of Pathology, Zhoushan Hospital, during January to August 2019 were collected. The number of pathological reports completed within 30 minutes and the rate of timely completion of pathological reports were calculated and compared with those calculated based on 1 051 pathological reports managed by the PDCA cycle during September to December 2019.Results:After management by the PDCA cycle, the rate of timely completion of frozen-section pathological reports was significantly increased from (84.51 ± 3.61)% to (91.87 ± 1.37)% ( t = 3.86, P < 0.05). Conclusion:Application of the PDCA cycle to pathology management can help monitor the completion of pathological reports on frozen sections. This facilitates determination of reasonable intervention measures and thereby increases the rate of timely completion of pathological reports on frozen sections.

Objective:To preliminarily investigate dermoscopic characteristics of trichoblastoma, and to provide ideas for clinical diagnosis of trichoblastoma.Methods:Clinical data were collected from 5 patients with trichoblastoma who underwent both dermoscopic and histopathological examinations in Wuhan No.1 Hospital from November 2018 to July 2021, and dermoscopic features were analyzed retrospectively.Results:According to the presence or absence of pigments, trichoblastoma was divided into 2 subtypes: pigmented trichoblastoma (3 cases) and non-pigmented trichoblastoma (2 cases) . Dermoscopic examination of the 3 cases of pigmented trichoblastoma showed blue-gray ovoid nests (3 cases) , arborizing vessels (2 cases) , blue-gray globules (2 cases) , bright white structureless areas (2 cases) , concentric structures (1 case) and ulcers (1 case) ; no yellow-whitish homogenous structure was found. As for non-pigmented trichoblastoma, dermoscopic features included arborizing vessels (2 cases) , yellow-whitish homogenous structures (2 cases) , bright white structureless areas (2 cases) and blue-gray globules (1 case) ; no ulcers or blue-gray ovoid nests were observed in either case.Conclusion:Dermoscopic patterns differ between pigmented and non-pigmented trichoblastoma, so dermoscopy can provide preliminary diagnostic clues for trichoblastoma.

Objective: To evaluate the effect of multidisciplinary cooperative pain management on the rapid recovery of patients with total hip and total knee arthroplasty. Methods: A total of 120 patients, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, aged 20-64 yr, with body mass index of 18-25 kg/m², were divided into 2 groups using a random number table method: test group (group T, n=66) and control group (group C, n=54). Multidisciplinary cooperative pain management mode was adopted for pain management in the perioperative period in group T, while traditional pain management was used in group C. Numeric rating scale scores were recorded at 4 h and 1, 2, 3 and 7 days after surgery and on discharge from hospital.The postoperative joint recovery time, length of hospital stay and satisfaction were recorded in two groups. Results: Compared with group C, the numeric rating scale scores were significantly decreased at 4 h and 1, 2, 3 and 7 days after surgery and on discharge from hospital, the postoperative joint recovery time and length of hospitalization were shortened, and the degree of satisfaction was increased in group T (P<0.05). Conclusion Multidisciplinary cooperative pain management can effectively promote the rapid recovery of patients with total hip and total knee replacement.

Objective To investigate the clinical features,polysomnography,imaging examination,genetic analysis and laboratory examination of eight patients with familial fatal insomnia (FFI).Methods The clinical data,neuropsychological examination,results of cerebrospinal fluid analysis,imaging examination and polysomnography of eight patients with FFI in Xuanwu Hospital,Capital Medical University from 2009 to 2018 were retrospectively analyzed and summarized.Results Among the eight FFI patients,there were 3 males and 5 females,the onset age being (49.8+14.3) years (19 to 64 years) and the course of disease being eight to 18 months.D178N mutation in the PRNP gene of chromosome 20 and 129 amino acid polymorphisms of M/M were found in genetic examination in all the eight patients,of which five patients had family history.All the patients had sleep disorders,sleep-related involuntary movement,sleep-related dyspnea,laryngeal stridor.All the patients showed rapid progressive dementia with or without symptoms or signs of psychosis,ataxia,pyramidal and extrapyramidal.All the eight patients had progressive sympathetic symptoms,including hypertension,sweating,tachycardia,irregular breathing,and dysarthria.Cerebrospinal fluid 14-3-3 protein was found positive in one patient,and negative in seven patients.Electroencephalograph showed diffuse slow wave and non periodic synchronous discharge.Single-photon emission computed tomography or 18F fluorodeoxyglucose positron emission tomography showed decreased thalamic glucose metabolism in three patients.Seven patients showed decreased total sleep time,sleep awakening cycle disorder,especially the reduction or loss of rapid eye movement,laryngeal stridor and involuntary movement in polysomnography.Conclusions FFI is characterized by sleep disorder,sleep-related involuntary movement,dyspnea,laryngosis,rapid progressive dementia and sympathetic symptoms.The family history,polysomnography and positron emission tomography are helpful for the diagnosis of FFI.PRNP gene detection can confirm the diagnosis of FFI.

Objective To evaluate the predictive value of ultrasonography of the respiratory variability index of inferior vena cava internal diameter (IVC-RVI) in preoperative fluid responsiveness evaluation of hip fracture in geriatric patients.Methods A retrospective case-control study was used to analyze 39 cases of elderly hip fractures admitted to the Daping Hospital of Army Medical Center from August 2017 to February 2018,including 15 males and 24 females,aged 65-92 years [(80.9 ±7.9)years].The heart rate (HR),mean arterial pressure(MAP),cardiac output (CO),and cardiac stoke volume (SV)were recorded five minutes after the patient entered the operating room and within 5 minures after capacity load test.The inferior vena cave during expiration (IVCe) and inferior vena cave during inspiration (IVCi) were measured by ultrasound before and after volume load test and the difference in IVC-RVI was calculated.Volumetric positive group were the cases of SV change (△SV) ≥15％ (positive group,n =21),and volume negative group were the cases of △SV ＜ 15％ (negative group,n=18).The correlations between various ultrasonic parameters and SV were analyzed by comparing HR,MAP,CO,SV,SV,IVCe,IVCi and IVC-RVI before and after the capacity load test.The predictive value of IVC-RVI for preoperative volumetric reactivity in elderly patients with hip fractures was evaluated by using the receiver operative characteristic (ROC) curve and Pearson correlation analysis.Results Prior to the volumetric load test,no significant difference was observed between the two groups concerning HR,MAP,CO,SV,and IVCe (P ＞ 0.05),IVCi in the positive group was significantly smaller than that in the negative group (P ＜ 0.05),and IVC-RVI in the positive group was significantly larger than that in the negative group (P ＜ 0.05).After the volumetric load test,there was no statistically significant difference between the two groups in CO,IVCe,IVCi,and IVC-RVI (P ＞ 0.05),HR in the positive group was smaller than that in the negative group (P ＜ 0.05),and MAP and SV in the positive group were significantly larger than that in the negative group (P ＜ 0.05).Compared with that before capacity load test,MAP,CO,and SV in the positive group increased after the capacity load test (P ＜ 0.05),while the HR difference was not statistically significant (P ＞ 0.05).HR,MAP,CO,and SV showed no significant difference in the negative group before and after capacity test (P ＞ 0.05).IVC-RVI assessed the area under the curve (AUC) was 0.80 ± 0.08 for preoperative volumetric responsiveness in elderly hip fractures (P ＜ 0.05),with a critical point of 20.69％,sensitivity of 77.78％,and specificity of 76.19％.After Pearson correlation analysis,IVC-RVI was positively related to △SV (OR =0.367,P ＜ 0.05).Conclusion Ultrasonography of the respiratory variability of IVC can predict the preoperative fluid responsiveness of hip fracture in geriatric patients and guide for clinical rehydration.

Objective To investigate the clinical effect on incomplete spinal injury by ganglioside intravenous injection combined with intrathecal injection.Methods From January 2011 to January 2015, seventy-nine cases with irreducible articular process interlocking of cervical spine fracture with dislocation of cervical spinal cord injury,underwent one stage anterior and posterior surgical treatment,postoperative routine use of antibiotics to prevent infection,and the hormone,dehydration to promote bone cell growth and neurotrophic drugs treatment.The patients were randomly divided into the intravenous injection group(42 cases),given intravenous injection of monalsialic acid four hexose ganglioside sodium(GM-1)40 mg/d,mecobalamin tablets 0.5 mg/time,3 times/d,30 d oral;the combined intrathecal injection group(37 cases)was given GM-1 40 mg/d,intravenous injection at 15 d after intrathecal injection,1 time a week 40 mg,with a total of 4 weeks.The degree of spinal cord injury was evaluated according to Frankel classification; cervical function was evaluated according to JOA score; bone graft fusion,stability of cervical spine and degree of spinal cord injury were evaluated by imaging.Results The operation time in the intravenous injection group and the combined intrathecal injection group were(4.15 ± 0.65)h and(4.10 ± 0.85)h,and the intraoperative blood loss was(850.50±35.10)ml and(858.60±25.20)ml,respectively,and there were no significant differences between the two groups(t=1.375,1.452,P>0.05).The total dose of GM-1 in the combined intrathecal injection group was(785.20 ± 3.28)mg,significantly higher than that in the intravenous injection group((610.55 ± 5.28) mg),the difference was statistically significant(t=12.542,P<0.05);79 patients were followed up for 12-24 months,with an average of(15.2 ± 1.3)months.The improvement rate of nerve function of the combined intrathecal injection group was(64.35±4.33)%,significantly higher than that in the intravenous injection group (55.50±5.44)%,the difference was statistically significant(t=8.813,P<0.05);the postoperative JOA scores of the intravenous injection group((13.55 ± 1.75)points)and combined intrathecal injection group((12.85 ±1.97)points)were significantly higher than those before the surgery((7.25± 0.83)points,(7.19± 0.93) points),the differences were statistically significant(P<0.05).There was no significant difference in the JOA scores between the two groups before and after the operation(P>0.05).At the last follow-up,X-ray showed bone fusion at the bone graft site,and the internal fixation was good and firm.MR showed that the degeneration signal area of the cervical spinal cord decreased in varying degrees,and edema and inflammatory reaction disappeared.Conclusion Postoperative treatment of ganglioside intravenous injection combined with intrathecal injection is safe and feasible in the treatment of incomplete cervical spinal cord injury caused by cervical fracture dislocation with irreducible articular process interlocking.

Objective To investigate the neuroprotective effect and its mechanism of p38 mitogenactivated protein kinase inhibitor after subarachnoid hemorrhage (SAH).Methods Twenty-seven SPF-grade adult male SD rats were selected to induce a SAH model using the prechiasmal pool blood injection.Three dead rats were excluded.Twenty-four rats were randomly divided into four groups:sham operation group,SAH group,dimethyl sulfoxide (DMSO) group,and DMSO +p38 inhibitor group (n =6 in each group).Western blot was used to detect the expression levels of p38,phosphorylation p38,Parkinson's disease protein 7 (DJ-1),autophagy associated gene 5 (Atg5),autophagy adaptor protein p62,microtubule-associated protein Ⅰ Light Chain 3 (LC3-Ⅰ),microtubule-associated protein Ⅱ light chain 3 Ⅱ (LC3-Ⅱ),and the Garcia neurological function score was used to judge the nerve injury.PC12 cell oxygenated hemoglobin was used to induce an in vitro SAH model.They were completely randomly divided into four groups:sham operative group,SAH group,DMSO group,and DMSO + p38 inhibitor group.Fluorescent probe JC-1 was used to observe the changes of mitochondrial membrane potential.Results (1) There were significant differences in the expression of p38,phosphorylation-p38 and DJ-1 in rat brain tissue among the 4 groups (F values were 94.959,150.293 and 698.476,respectively,all P ＜ 0.01).There were significant differences in mitochondrial membrane potential in PC12 cells among the 4 groups (F value was 24.989,P ＜ 0.01).There were significant differences in the expression levels of autophagy related protein LC3-Ⅱ/LC3-Ⅰ ratio,Atg5 and p62 in rat brain tissue among the 4 groups (F values were 235.319,110.490 and 36.311,respectively,all P ＜ 0.01).There was significant difference in nerve function score among the 4 groups (F value was 25.550,P ＜ 0.01).(2) Compared with the sham operative group,the expression levels of p38,phosphorylation-p38 and DJ-1 were upregulated significantly after SAH (from 0.43 ±0.06,0.41 ±0.02 and 0.07 ±0.01 to 0.61 ± 0.08,0.79 ± 0.07 and 0.17 ± 0.03,respectively,all P ＜ 0.01),mitochondria membrane potential depolarization (from 8.29 ±0.28 to 9.23 ±0.42,P ＜0.01);upregulation of Atg5 expression and increase of LC3-Ⅱ/LC3-Ⅰratio (from 0.23 ± 0.04 and 0.25 ± 0.04 to 0.47 ± 0.04 and 0.46 ± 0.04,respectively,all P ＜ 0.01),down regulation of p62 expression (from 1.09 ± 0.14 to 0.54 ± 0.10,P ＜ 0.01);neurological score was decreased (from 17.5 ± 0.6 to 11.3 ± 2.7,P ＜ 0.01);p38 inhibitor was significantly down regulated the expression of phosphorylation-p38 after SAH (from 0.79 ± 0.07 to 0.47 ± 0.04,P ＜ 0.01),the expression of DJ-1 was up-regulated (from 0.17 ± 0.03 to 1.02 ± 0.06,P ＜ 0.01),mitochondrial membrane potential recovery (from 9.23 ±0.42 to 8.47 ±0.36,P ＜0.01),cell autophagy related protein LC3-Ⅱ/LC3-Ⅰ ratio and Atg5 were upregulated(from 0.46 ±0.04 and 0.47 ±0.04 to 0.77 ± 0.06 and 0.95 ± 0.12,all P ＜ 0.01),p62 expression returned to the levels of SAH group (from 0.57 ± 0.09,to 0.54 ± 0.10,P =0.650),and the neurological score was significantly improved (from 11.3 ± 2.7 to 15.5 ± 1.0,P ＜0.01).Conclusions After SAH,the p38 inhibitor downregulates the activity of2 phosphorylation p38.It may inhibit abnormal autophagy and maintain mitochondrial function by up-regulating the expression of DJ-1 protein,and then play a neuroprotective function.